Prevention of enamel demineralization: An in-vitro study using light-cured filled sealant

Introduction: Enamel demineralization is an undesirable side effect of orthodontic treatment with fixed appliances. The purpose of this in-vitro study was to evaluate the efficacy of applying a light-cured filled sealant onto the buccal tooth surfaces to prevent demineralization. Methods: Fifty extracted human third molars were allocated to 1 of 5 groups: (1) enamel surface untreated (control); (2) surface etched; (3) fluoride varnish applied; (4) enamel etched and coated with a light-cured, unfilled sealant (control sealant); and (5) enamel etched and coated with a light-cured, filled sealant (Pro Seal, Reliance Orthodontic Products, Itasca, Ill). The enamel surface of each specimen was brushed for 15,000 strokes with nonfluoride toothpaste slurry with a piston-action brushing machine under a standardized load. All samples were then cycled for 14 days through a daily procedure of demineralization for 6 hours and remineralization for 17 hours. Then the teeth were sectioned and evaluated quantitatively by cross-sectional microhardness testing. Results: Demineralization in the Pro Seal group was significantly less (P < .05) than in the other groups. Teeth treated with fluoride varnish exhibited 30% less demineralization than the control teeth, the enamel-etched teeth, and the teeth treated with a light-cured, unfilled sealant (P < .05). Conclusions: Pro Seal can be considered for use as a preventive method to reduce enamel demineralization adjacent to orthodontic attachments, particularly in patients who exhibit poor compliance with oral hygiene and home fluoride use.